INTRAOPERATIVE EPIDURAL MORPHINE, FENTANYL, AND DROPERIDOL FOR CONTROL OF PAIN AFTER SPINAL SURGERY - A PROSPECTIVE, RANDOMIZED, PLACEBO-CONTROLLED, AND DOUBLE-BLIND TRIAL

The present study was conducted to investigate the analgesic effects o f intra-operatively administered epidural morphine in patients undergo ing surgery for lumbar disc disease. Three treatment groups were const ituted: one with 5,0 mg morphine and 2,5 mg dehydrobenzperidol (DHB) i n 10 mi physiological saline, one with 5,0 mg morphine and 0,1 mg fent anyl in the same amount of saline, and one placebo group with saline o nly. The test solution was injected epidurally via catheter after haem ostasis and before closure of the wound. Sixty eight patients were ran domly assigned to each of the three groups and subjected to a double-b lind evaluation. In the morphine/fentanyl and morphine/droperidol grou ps, significantly better analgesia was found as compared to the placeb o group. No significant difference was found between the morphine/fent anyl and morphine/droperidol groups considering side effects of therap y, as well as duration and quality of analgesia. The side effects in t he treatment groups were only slight and not significantly different f rom the placebo group. It was shown that additional epidural fentanyl offers no significant improvement of postoperative analgesia. No signi ficant reduction of adverse effects could be found in the morphine/dro peridol group compared to the morphine/fentanyl group. In conclusion, the intra-operative epidural application of morphine is a safe, effect ive and simple method for achieving sufficient analgesia in the first 24 hours after lumbar spinal surgery for disc disease.